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Brain aneurysm repair

Aneurysm repair - cerebral; Cerebral aneurysm repair; Coiling; Saccular aneurysm repair; Berry aneurysm repair; Fusiform aneurysm repair; Dissecting aneurysm repair; Endovascular aneurysm repair - brain; Subarachnoid hemorrhage - aneurysm

Brain aneurysm repair is surgery to correct an aneurysm in or near the brain. This is a weak area in a blood vessel wall that causes the vessel to bulge or balloon out and sometimes burst (rupture). It may cause:

Description

There are two common methods used to repair an aneurysm:

During aneurysm clipping:

During endovascular repair (surgery) of an aneurysm:

Why the Procedure Is Performed

If an aneurysm in the brain breaks open (ruptures), it is an emergency that needs medical treatment in a hospital. Often a rupture is treated with surgery, especially endovascular surgery.

A person may have an unruptured aneurysm without any symptoms. This kind of aneurysm may be found when an MRI or CT scan of the brain is done for another reason.

Risks

Risks of anesthesia and surgery in general are:

Risks of brain surgery are:

Surgery on any one area of the brain may cause problems that may be mild or severe. They may last a short while or they may not go away.

Signs of brain and nervous system (neurological) problems include:

You may need another surgery to further treat the aneurysm or to treat a complication.

Before the Procedure

This procedure is often done as an emergency.

If it is not an emergency, tell your surgeon or nurse if:

During the week before your surgery:

On the day of surgery:

After the Procedure

A hospital stay for endovascular repair of an aneurysm may be as short as 1 to 2 days if there was no bleeding before surgery.

The hospital stay after craniotomy and aneurysm clipping is usually 4 to 6 days. If there is bleeding or other problems, such as narrowed blood vessels (vasospasm) in the brain or a buildup of fluid in the brain, the hospital stay can be 2 weeks, or longer.

You will probably have imaging tests of the blood vessels (angiogram) in the brain before you are sent home, and possibly once a year for a few years.

Follow instructions on caring for yourself at home.

Ask your surgeon if it will be safe for you to have imaging tests such as angiogram, CT angiogram, or MRI scans of the head in the future.

Outlook (Prognosis)

After successful surgery for a bleeding aneurysm, it is uncommon for it to bleed again.

The outlook also depends on whether brain damage occurred from bleeding before, during, or after surgery.

Most of the time, surgery can prevent a brain aneurysm that has not caused symptoms from becoming larger and breaking open.

You may have more than one aneurysm or the aneurysm that was coiled might grow back. After coiling repair, you will need to be seen by your surgeon every year.

Related Information

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Communicating with someone with aphasia
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Communicating with someone with dysarthria
Caring for muscle spasticity or spasms
Swallowing problems
Brain aneurysm repair - discharge
Brain surgery - discharge
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Stroke - discharge

References

Altschul D, Vats T, Unda S. Endovascular treatment of brain aneurysms. In: Ambrosi PB, ed. New Insight Into Cerebrovascular Diseases - An Updated Comprehensive Review.www.intechopen.com/books/new-insight-into-cerebrovascular-diseases-an-updated-comprehensive-review/endovascular-treatment-of-brain-aneurysms. IntechOpen; 2020:chap: 11. Reviewed August 1, 2019. Accessed June 6, 2024.

American Stroke Association website. What you should know about cerebral aneurysms. www.stroke.org/en/about-stroke/types-of-stroke/hemorrhagic-strokes-bleeds/what-you-should-know-about-cerebral-aneurysms#. Reviewed December 5, 2018. Accessed June 6, 2024.

Le Roux PD, Mack WJ, Winn HR. Surgical decision making for the treatment of intracranial aneurysms. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 427.

Levy ML, Levy DM, Manna B. Pediatric Cerebral Aneurysm. [Updated 2021 Aug 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; May 10, 2022. www.ncbi.nlm.nih.gov/books/NBK537085/. Updated August 8, 2023. Accessed June 6, 2024.

Macdonald RL. Perioperative management of subarachnoid hemorrhage. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 428.

Magiricu D, Garcia-Rybkin M. Isolated third nerve cranial palsy: complication of brain aneurysm. Surgical Science. 2024;15(4):225-231. www.scirp.org/journal/paperinformation?paperid=132665.

National Institute of Neurological Disorders and Stroke website. Cerebral aneurysms. www.ninds.nih.gov/health-information/disorders/cerebral-aneurysms. Updated November 28, 2023. Accessed June 6, 2024.

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Review Date: 5/10/2024  

Reviewed By: Luc Jasmin, MD, Ph.D., FRCS (C), FACS, Department of Neuroscience, Guam Regional Medical City, Guam; Department of Surgery, Johnson City Medical Center, TN; Department of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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